Membership Registration Fill in this short form to apply for membership of the Ireland Japan Association Payment Options* Pay Online Now Pay later Which category of membership do you qualify for?*Corporate MembershipFamily / Individual SubscriptionJET Alumni, JLTI Members & StudentsWhich category of membership do you qualify for?*Corporate MembershipFamily / Individual SubscriptionJET Alumni, JLTI Members & StudentsCorporate Applicantion DetailsCompany Name* Name and Title of Company Representative* Company Description*Corporate members are entitled to have their logos and contact details displayed on our website. Do you agree to this?* Yes No Applicant DetailsName of Applicant* First Last Phone*Address* Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands FaxEmail* Reason for application*Year of JET participation (if applicable) Student Card Number (if applicable) How did you hear about the IJA?*Please selectIJA EventEmbassy EventJapan ExperienceReferral/FriendSearch EngineOtherOther:Please let us know where you heard about IJA Data Protection Terms & ConditionsData Protection Terms & Conditions Under the terms of Data Protection Legislation, the Ireland Japan Association will use contact information provided to it by its members for the purposes of the Association and will not release it to third parties without the consent of the members concerned. From time to time, members request contact details for other members and these are provided on the understanding that they are for the purposes of the Association.Tick here if you agree that your contact details are shared with other IJA members but not with 3rd parties outside the IJA network please tick here. Total € 0.00 Sign up to receive news & special offersCheck the box below to sign up to our mailing list. You can unsubscribe at any time. Please add me to the IJA mailing list Credit CardCard Details Cardholder Name Data Protection*This form collects your details above so we can contact you back in relation to your booking. Please see our privacy policy for more information. I consent to you collecting my details above. * CommentsThis field is for validation purposes and should be left unchanged.
Leave a Reply
Want to join the discussion?Feel free to contribute!